Trends and Clinical Outcomes in Patients Undergoing Primary Percutaneous Revascularisation for ST-elevation Myocardial Infarction

A Single Centre Experience

Luke P. Dawson, Josephine Warren, Juan Mundisugih, Viveka Nainani, William Chan, Dion Stub, Archer Broughton, Andrew J. Taylor, Antony Walton, Stephen J. Duffy, James A. Shaw

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. Methods: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified. Detailed review of their procedure reports was performed and 30-day and 12-month clinical outcomes were recorded including major adverse cardiac events (MACE). Results: There was a total of 445 patients aged 60.6. ±. 12.4 years with 369 (82.9%) male. There was a significant increase in radial access use over the six-year period 0/49 (0%) in 2010 vs 56/113 (49.6%) in 2015 (p. <. 0.01). There was a significant reduction in the use of IIb/IIIa receptor antagonists during the period 29/49 (59%) in 2010 vs 24/113 (21%) in 2015 (p. <. 0.01) and use of aspiration thrombectomy 15/49 (31%) in 2010 vs 19/113 (17%) in 2015 (p. <. 0.01). There was no significant reduction in major bleeding over this period with 2/49 (4%) in 2010 vs 5/108 (5%) in 2015 (p = 0.32). Thirty-day and 12-month mortality was also unchanged. Conclusion: Between 2010 and 2015 there has been a significant increase in the use of radial access and a reduction in the use of glycoprotein IIb/IIIa antagonists and aspiration thrombectomy in patients undergoing PPCI. This was not associated with changes in major bleeding or 30-day or 12-month mortality.

Original languageEnglish
Pages (from-to)683-692
Number of pages10
JournalHeart Lung and Circulation
Volume27
Issue number6
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Aspiration thrombectomy
  • Myocardial infarction
  • Percutaneous coronary intervention

Cite this

@article{0715a99498e04065b607ef826b0197e6,
title = "Trends and Clinical Outcomes in Patients Undergoing Primary Percutaneous Revascularisation for ST-elevation Myocardial Infarction: A Single Centre Experience",
abstract = "Background: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. Methods: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified. Detailed review of their procedure reports was performed and 30-day and 12-month clinical outcomes were recorded including major adverse cardiac events (MACE). Results: There was a total of 445 patients aged 60.6. ±. 12.4 years with 369 (82.9{\%}) male. There was a significant increase in radial access use over the six-year period 0/49 (0{\%}) in 2010 vs 56/113 (49.6{\%}) in 2015 (p. <. 0.01). There was a significant reduction in the use of IIb/IIIa receptor antagonists during the period 29/49 (59{\%}) in 2010 vs 24/113 (21{\%}) in 2015 (p. <. 0.01) and use of aspiration thrombectomy 15/49 (31{\%}) in 2010 vs 19/113 (17{\%}) in 2015 (p. <. 0.01). There was no significant reduction in major bleeding over this period with 2/49 (4{\%}) in 2010 vs 5/108 (5{\%}) in 2015 (p = 0.32). Thirty-day and 12-month mortality was also unchanged. Conclusion: Between 2010 and 2015 there has been a significant increase in the use of radial access and a reduction in the use of glycoprotein IIb/IIIa antagonists and aspiration thrombectomy in patients undergoing PPCI. This was not associated with changes in major bleeding or 30-day or 12-month mortality.",
keywords = "Aspiration thrombectomy, Myocardial infarction, Percutaneous coronary intervention",
author = "Dawson, {Luke P.} and Josephine Warren and Juan Mundisugih and Viveka Nainani and William Chan and Dion Stub and Archer Broughton and Taylor, {Andrew J.} and Antony Walton and Duffy, {Stephen J.} and Shaw, {James A.}",
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Trends and Clinical Outcomes in Patients Undergoing Primary Percutaneous Revascularisation for ST-elevation Myocardial Infarction : A Single Centre Experience. / Dawson, Luke P.; Warren, Josephine; Mundisugih, Juan; Nainani, Viveka; Chan, William; Stub, Dion; Broughton, Archer; Taylor, Andrew J.; Walton, Antony; Duffy, Stephen J.; Shaw, James A.

In: Heart Lung and Circulation, Vol. 27, No. 6, 06.2018, p. 683-692.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Trends and Clinical Outcomes in Patients Undergoing Primary Percutaneous Revascularisation for ST-elevation Myocardial Infarction

T2 - A Single Centre Experience

AU - Dawson, Luke P.

AU - Warren, Josephine

AU - Mundisugih, Juan

AU - Nainani, Viveka

AU - Chan, William

AU - Stub, Dion

AU - Broughton, Archer

AU - Taylor, Andrew J.

AU - Walton, Antony

AU - Duffy, Stephen J.

AU - Shaw, James A.

PY - 2018/6

Y1 - 2018/6

N2 - Background: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. Methods: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified. Detailed review of their procedure reports was performed and 30-day and 12-month clinical outcomes were recorded including major adverse cardiac events (MACE). Results: There was a total of 445 patients aged 60.6. ±. 12.4 years with 369 (82.9%) male. There was a significant increase in radial access use over the six-year period 0/49 (0%) in 2010 vs 56/113 (49.6%) in 2015 (p. <. 0.01). There was a significant reduction in the use of IIb/IIIa receptor antagonists during the period 29/49 (59%) in 2010 vs 24/113 (21%) in 2015 (p. <. 0.01) and use of aspiration thrombectomy 15/49 (31%) in 2010 vs 19/113 (17%) in 2015 (p. <. 0.01). There was no significant reduction in major bleeding over this period with 2/49 (4%) in 2010 vs 5/108 (5%) in 2015 (p = 0.32). Thirty-day and 12-month mortality was also unchanged. Conclusion: Between 2010 and 2015 there has been a significant increase in the use of radial access and a reduction in the use of glycoprotein IIb/IIIa antagonists and aspiration thrombectomy in patients undergoing PPCI. This was not associated with changes in major bleeding or 30-day or 12-month mortality.

AB - Background: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. Methods: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified. Detailed review of their procedure reports was performed and 30-day and 12-month clinical outcomes were recorded including major adverse cardiac events (MACE). Results: There was a total of 445 patients aged 60.6. ±. 12.4 years with 369 (82.9%) male. There was a significant increase in radial access use over the six-year period 0/49 (0%) in 2010 vs 56/113 (49.6%) in 2015 (p. <. 0.01). There was a significant reduction in the use of IIb/IIIa receptor antagonists during the period 29/49 (59%) in 2010 vs 24/113 (21%) in 2015 (p. <. 0.01) and use of aspiration thrombectomy 15/49 (31%) in 2010 vs 19/113 (17%) in 2015 (p. <. 0.01). There was no significant reduction in major bleeding over this period with 2/49 (4%) in 2010 vs 5/108 (5%) in 2015 (p = 0.32). Thirty-day and 12-month mortality was also unchanged. Conclusion: Between 2010 and 2015 there has been a significant increase in the use of radial access and a reduction in the use of glycoprotein IIb/IIIa antagonists and aspiration thrombectomy in patients undergoing PPCI. This was not associated with changes in major bleeding or 30-day or 12-month mortality.

KW - Aspiration thrombectomy

KW - Myocardial infarction

KW - Percutaneous coronary intervention

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U2 - 10.1016/j.hlc.2017.06.722

DO - 10.1016/j.hlc.2017.06.722

M3 - Article

VL - 27

SP - 683

EP - 692

JO - Heart Lung and Circulation

JF - Heart Lung and Circulation

SN - 1443-9506

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ER -